Health officials ready for TB uptick

Amarillo public health officials say they're prepared to deal with a highly contagious and potentially deadly disease that has affected a small number of people in the area.

Tuberculosis

Cases in Potter and Randall counties

2005: 6

2006: 7

2007: 4

2008: 9

2009: 10

Source: Amarillo Public Health Department

Tuberculosis was nearly eradicated until the early 1980s when it repopulated through HIV-positive patients with weak immune systems. The disease spread steadily through the '80s but has steadily declined the past two decades.

However, there has been a uptick in the number of local cases the last two years.

The Amarillo Public Health Department tracked nine total cases of tuberculosis in Potter and Randall counties in 2008 and then 10 last year.

Dr. Roger Smalligan, the health authority for Potter and Randall counties appointed to the post late last month, called the increase insignificant given the number of cases.

"Thankfully with modern science we've found the right cocktail of medicine to treat it," said Smalligan, who moved to Amarillo from Tennessee in September to head the internal medicine department at the Texas Tech School of Medicine.

Smalligan has experience treating large numbers of tuberculosis patients from nine years of working at a hospital in the jungles of Ecuador.

Smalligan's experience treating tuberculosis patients was a determining factor in his appointment as health authority. The Amarillo Public Health Department is charged with monitoring the disease as part of its responsibility to control infectious diseases.

Tuberculosis, known as "consumption" in the 19th century, typically affects the lungs but can spread to other parts of the body. It can lead to serious complications and even death, especially if the body is weakened by other health problems. Symptoms include weight loss, night sweats, fever and a persistent cough. It is most commonly spread by coughing.

The disease is rare in the U.S. and can usually be treated with antibiotics. However, it's a leading cause of death in less developed parts of the world.

The modest increase public health officials have seen locally runs counter to national, state and regional trends.

The tuberculosis incidence rates for the 41-county health service region that includes Amarillo and Lubbock have fallen each year from 2003 to 2007, according to the Department of State Health Services. The number of cases in 2003 - 28 - fell by half to 14 by 2007, according to state data.

The national rate of TB infection in 2008 - 4.2 cases per 100,000 people - was the lowest on record since national reporting began in 1953, according to the Centers for Disease Control and Prevention.

The CDC reported 644 deaths from TB in 2006, the most recent year data is available. That's nearly a 50 percent decline from 1996 when more than 1,200 people in the U.S. died of the disease.

"The vast majority of patients are cured within six months," Smalligan said.

Recovery with regular treatment is "outstanding," Smalligan said.

Public Health Department Director Matt Richardson said they staff one part-time nurse to handle tuberculosis services.

The department receives $20,000 from the Department of State Health Services for tuberculosis services. Richardson estimates it costs from $50,000 to $70,000 a year to handle patients, testing and treatment of TB in the two counties.

The remaining money comes from the department's administrative fund that covers supplies and support staff and comes from the Amarillo Hospital District.

Richardson said the increase in tuberculosis will require more resources.

Smalligan knows firsthand how deadly tuberculosis can be if it goes untreated and unmonitored. He moved to Ecuador in 2004 to work at a Christian hospital as part of a mission that sends doctors to third-world counties. He treated a wide variety of patients and his salary was paid through donations.

He said he treated from 25 to 30 tuberculosis patients a year while in South America.

"I found it fascinating," Smalligan said. "The patients are in great need. There's a great lack of physicians."